N\u00eb nj\u00eb k\u00ebndv\u00ebshtrim t\u00eb past\u00ebr biologjik, trupi i njeriut endet instinktivisht mes rrjet\u00ebs s\u00eb indeve dhe objekteve q\u00eb nuk i njeh si t\u00eb vetat, p.sh implantet e gjirit dhe pajisjet e tjera mjek\u00ebsore, n\u00eb m\u00ebnyr\u00eb q\u00eb t\u00eb shmang\u00eb nd\u00ebrhyr\u00ebs t\u00eb ndrysh\u00ebm nga jasht\u00eb.<\/p>\n\n\n\n
N\u00eb m\u00ebnyr\u00eb tipike dhe natyrale, ajo mas\u00eb e krijuar mbetet e but\u00eb dhe e zhd\u00ebrvjell\u00ebt dhe kurr\u00eb nuk e vini re, por ajo luan rolin e nj\u00eb barriere midis indeve t\u00eb trupit tuaj dhe trupit t\u00eb huaj.<\/p>\n\n\n\n
Megjithat\u00eb, ndodh q\u00eb kur k\u00ebto veshje krejt\u00ebsisht natyrale, t\u00eb pasura me kolagjen nxiten, zakonisht nga bakteret ose gjaku, t\u00eb dy agjent\u00eb inflamator\u00eb, at\u00ebher\u00eb nisin t\u00eb ngurt\u00ebsohen, trashen, kalcifikohen dhe\/ose shtremb\u00ebrojn\u00eb implantin, gj\u00eb q\u00eb mund t\u00eb \u00e7oj\u00eb n\u00eb dhimbje, fenomeni, i njohur si kontraktura kapsulare. Ajo konsiderohet t\u00eb jet\u00eb rreziku num\u00ebr nj\u00eb i implanteve t\u00eb gjirit.<\/p>\n\n\n\n
\u00c7far\u00eb e shkakton kontraktur\u00ebn kapsulare?<\/strong><\/p>\n\n\n\n Duke qen\u00eb se nuk kemi nj\u00eb p\u00ebrkufizim t\u00eb qart\u00eb e shterues, kontraktura kapsulare besohet t\u00eb ndodh\u00eb p\u00ebr shkak t\u00eb nj\u00eb biofilmi ose shtrese t\u00eb holl\u00eb t\u00eb bakterieve, p\u00ebrgjith\u00ebsisht bakterie q\u00eb gjenden zakonisht n\u00eb l\u00ebkur\u00ebn ton\u00eb, t\u00eb cilat formohen rreth implantit n\u00eb koh\u00ebn e nd\u00ebrhyrjes. Trupi reagon ndaj baktereive duke rritur sasin\u00eb e formimit t\u00eb indeve. T\u00eb tjer\u00eb faktor\u00eb q\u00eb ndikojn\u00eb (m\u00eb pak t\u00eb zakonsh\u00ebm) jan\u00eb hematoma dhe seroma, sasi gjaku ose l\u00ebngu q\u00eb grumbullohen gjat\u00eb ose pas nd\u00ebrhyrjes, si edhe shk\u00ebputja e implantit ose nj\u00eb predispozit\u00eb e mundshme gjenetike p\u00ebr formimin e mas\u00ebs s\u00eb indit agresiv.<\/p>\n\n\n\n Vlen t\u00eb theksohet se nuk \u00ebsht\u00eb e th\u00ebn\u00eb q\u00eb kontraktimi domosdoshm\u00ebrisht do t\u00eb jet\u00eb problematik, madje shtoj k\u00ebtu se shpesh vet\u00ebm nivelet m\u00eb t\u00eb avancuara t\u00eb kontraktimit k\u00ebrkojn\u00eb trajtim.<\/p>\n\n\n\n Kush \u00ebsht\u00eb m\u00eb i prirur p\u00ebr kontraktur\u00eb kapsulare?<\/strong><\/p>\n\n\n\n Historikisht, kirurg\u00ebt plastik\u00eb kan\u00eb v\u00ebn\u00eb re nj\u00eb shkall\u00eb m\u00eb t\u00eb lart\u00eb t\u00eb kontrakturave me implantet e silikonit kundrejt atyre t\u00eb kripura dhe t\u00eb l\u00ebmuara si edhe atyre t\u00eb tekstur\u00ebs, referuar statistikave t\u00eb mjek\u00ebve n\u00eb SHBA.<\/p>\n\n\n\n P\u00ebrtej llojit t\u00eb implantit, ekziston gjithashtu nj\u00eb marr\u00ebdh\u00ebnie e ngusht\u00eb mes vendndodhjes s\u00eb prerjes dhe kontraktur\u00ebs kapsulare, n\u00ebp\u00ebrmjet disa pikave hyr\u00ebse q\u00eb jan\u00eb provuar si m\u00eb t\u00eb sigurta se t\u00eb tjerat.<\/p>\n\n\n\n Implantet e aplikuara p\u00ebrmes nj\u00eb prerjeje t\u00eb palosjes inframamare kan\u00eb rezultuar t\u00eb ken\u00eb norma m\u00eb t\u00eb ul\u00ebta t\u00eb kontraktur\u00ebs kapsulare, p\u00ebr shkak t\u00eb nivelit m\u00eb t\u00eb ul\u00ebt t\u00eb bakterieve t\u00eb implantit, n\u00eb krahasim me prerjet areolare ose aksilare.<\/p>\n\n\n\n Me fjal\u00eb t\u00eb tjera, l\u00ebkura e palosjes s\u00eb gjirit n\u00eb m\u00ebnyr\u00eb tipike mbart m\u00eb pak bakterie sesa ajo e sqetull\u00ebs, \u00e7udit\u00ebrisht dhe kompleksit thith\u00eb-areolar, i cili n\u00eb fakt sekreton sasin\u00eb e duhur t\u00eb bakterieve natyrore, n\u00eb propocion t\u00eb drejt\u00eb me at\u00eb t\u00eb gj\u00ebndrave t\u00eb qum\u00ebshtit.<\/p>\n\n\n\n Pozicioni i nj\u00eb implanti mund t\u00eb ndikoj\u00eb n\u00eb shkall\u00ebn e tij t\u00eb rrezikut, ata q\u00eb vendosen mbi muskulin e kraharorit (n\u00eb at\u00eb q\u00eb njihet si pozicioni prepektoral ose n\u00ebn -gj\u00ebndror) jan\u00eb m\u00eb t\u00eb rrezikuara nga kontraktura sesa implantet q\u00eb jan\u00eb t\u00eb aplikuara n\u00ebn muskul. N\u00eb t\u00eb v\u00ebrtet\u00eb, studimet tregojn\u00eb se vendosja e implantit pas muskujve dhe jo n\u00eb krye, mund t\u00eb parandaloj\u00eb kontraktur\u00ebn kapsulare. Arsyeja \u00ebsht\u00eb se sa her\u00eb q\u00eb p\u00ebrkulni muskulin tuaj gjoksor, ju n\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb masazhoni implantin dhe duke e l\u00ebvizur at\u00eb, ju e mbani kapsul\u00ebn mir\u00eb dhe n\u00eb gjendje t\u00eb hapur.<\/p>\n\n\n\n Nd\u00ebrsa disa kirurg\u00eb rekomandojn\u00eb masazh n\u00eb m\u00ebnyr\u00eb rutinore t\u00eb gjinjve t\u00eb zmadhuar, p\u00ebr t\u2019i mbajtur kapsulat t\u00eb buta, n\u00ebse implanti \u00ebsht\u00eb pas muskujve, ju n\u00eb fakt po merrni ekuivalentin e nj\u00eb masazhi ditor sa her\u00eb q\u00eb ngriheni nga shtrati ose hapni frigoriferin. Tek e fundit, ajo q\u00eb ju k\u00ebrkohet \u00ebsht\u00eb t\u00eb vini n\u00eb l\u00ebvizje n\u00eb nj\u00eb m\u00ebnyr\u00eb apo n\u00eb nj\u00eb tjet\u00ebr muskulin tuaj gjoksor.<\/p>\n\n\n\n Gjithashtu n\u00eb rrezik t\u00eb shtuar t\u00eb kontrakturave kapsulare jan\u00eb pacientet q\u00eb pin\u00eb duhan, plus kushdo q\u00eb ka implante t\u00eb vjet\u00ebruara, pacient\u00eb pas ristrukturimit t\u00eb gjirit (pas mastektomis\u00eb), ato q\u00eb kan\u00eb aplikuar rrezatim n\u00eb gjoks, si edhe ato q\u00eb kan\u00eb t\u00eb trash\u00ebguar histori t\u00eb kontraktur\u00ebs kapsulare. Un\u00eb gjithmon\u00eb ua p\u00ebrs\u00ebris pacienteve t\u00eb mia se n\u00ebse keni kaluar nj\u00eb her\u00eb kontraktur\u00eb kapsulare, jeni t\u00eb predispozuara q\u00eb ajo t\u00eb p\u00ebrs\u00ebritet.<\/p>\n\n\n\n Si e minimizojn\u00eb kirurg\u00ebt rrezikun e kontraktur\u00ebs kapsulare?<\/strong><\/p>\n\n\n\n Duke u angazhuar maksimalisht drejt p\u00ebrqasjes me teknikat m\u00eb t\u00eb avancuara p\u00ebr t\u00eb zvog\u00ebluar ndotjen bakteriale dhe gjakderdhjen gjat\u00eb procedur\u00ebs s\u00eb zmadhimit t\u00eb gjoksit, kirurg\u00ebt plastik\u00eb kan\u00eb minimizuar n\u00eb m\u00ebnyr\u00eb dramatike incidenc\u00ebn e kontrakturave kapsulare. Nd\u00ebr standardet tashm\u00eb t\u00eb panegociueshme aseptike t\u00eb kirurgjis\u00eb s\u00eb gjirit: p\u00ebrdorimi i mburojave t\u00eb thithave p\u00ebr t\u00eb parandaluar infektimin e baktereve; kryerja e nj\u00eb diseksioni t\u00eb but\u00eb dhe pa gjak; p\u00ebrgatitja e xhepit t\u00eb gjirit me nj\u00eb zgjidhje antibiotike\/antiseptike; ndryshimi i dorezave kirurgjikale pas vendosjes s\u00eb \u00e7do implanti; shmangia e nj\u00eb \u201ctubi kullimi\u201d duke p\u00ebrdorur Keller Funnel me an\u00eb t\u00eb s\u00eb cilit implanti transferohet nga kutia sterile, n\u00eb m\u00ebng\u00ebn e gypit steril, drejtp\u00ebrdrejt tek pacienti, pa trajtim tjet\u00ebr.<\/p>\n\n\n\n N\u00eb nj\u00eb p\u00ebrmbledhje t\u00eb vitit 2016, t\u00eb botuar n\u00eb Aesthetic Surgery Journal, kirurg\u00ebt vun\u00eb re nj\u00eb ulje prej 54% t\u00eb shkall\u00ebs s\u00eb rioperimit p\u00ebr shkak t\u00eb kontraktur\u00ebs kapsulare n\u00eb pacient\u00ebt par\u00ebsor\u00eb t\u00eb gjirit, implantet e t\u00eb cil\u00ebve u vendos\u00ebn me nj\u00eb gyp Keller.<\/p>\n\n\n\n Mjek\u00ebt e tjer\u00eb tani po vendosin implantin n\u00ebn muskulin e kraharorit dhe implantet e silikonit jan\u00eb t\u00eb gjitha implante xheli koheziv, q\u00eb do t\u00eb thot\u00eb se xheli \u00ebsht\u00eb i nd\u00ebrlidhur n\u00eb m\u00ebnyr\u00eb t\u00eb atill\u00eb, q\u00eb t\u00eb mos rrjedh\u00eb dhe v\u00eb n\u00eb l\u00ebvizje kapsul\u00ebn, dy faktor\u00eb kritik\u00eb q\u00eb kan\u00eb ndihmuar n\u00eb uljen e niveleve t\u00eb nd\u00ebrlikimeve t\u00eb implantit t\u00eb gjirit gjat\u00eb dekad\u00ebs s\u00eb fundit.<\/p>\n\n\n\n Nd\u00ebrsa kontraktura kapsulare mbetet nd\u00ebr rreziqet m\u00eb t\u00eb zakonshme t\u00eb implantit t\u00eb gjirit, kirurg\u00ebt pajtohen n\u00eb faktin se shanset p\u00ebr ta zhvilluar at\u00eb kan\u00eb r\u00ebn\u00eb ndjesh\u00ebm, ve\u00e7an\u00ebrisht p\u00ebr pacient\u00ebt e koh\u00ebve t\u00eb fundit. Megjithat\u00eb nuk jemi p\u00ebrpara t\u00eb dh\u00ebnave totalisht t\u00eb besueshme, kjo p\u00ebr faktin se t\u00eb dh\u00ebnat e botuara n\u00eb literatur\u00ebn shkencore shpesh nuk b\u00ebjn\u00eb dallim mes llojit t\u00eb implantit, vendosjes s\u00eb xhepit, ose vendndodhjes s\u00eb prerjes, duke qen\u00eb se jan\u00eb t\u00eb dh\u00ebna q\u00eb pasqyrojn\u00eb studimet e kryera shum\u00eb vite m\u00eb par\u00eb, para se teknikat e sotme t\u00eb standardeve bashk\u00ebkohore t\u00eb ishin gjer\u00ebsisht t\u00eb miratuara nd\u00ebrkomb\u00ebtarisht.<\/p>\n\n\n\n Cilat jan\u00eb simptomat e kontraktur\u00ebs kapsulare?<\/strong><\/p>\n\n\n\n Shumica e rasteve t\u00eb kontrakturave kapsulare ndodhin brenda dy viteve t\u00eb para pas aplikimit t\u00eb implantit.<\/p>\n\n\n\n Si fillim, pacient\u00ebt mund t\u00eb v\u00ebrejn\u00eb nj\u00eb shtr\u00ebngim n\u00eb gjinjt\u00eb e tyre, pa arritur akoma t\u00eb v\u00ebn\u00eb re ndonj\u00eb ndryshim t\u00eb dalluesh\u00ebm n\u00eb pamjen e tyre t\u00eb jashtme. Nd\u00ebrsa indi i shtres\u00eb s\u00eb l\u00ebkur\u00ebs trashet, ai mund t\u00eb shtrydh\u00eb dhe zhvendos\u00eb implantin, duke e shtyr\u00eb at\u00eb lart dhe duke shtremb\u00ebruar form\u00ebn e gjirit t\u00eb prekur. Gjinjt\u00eb q\u00eb vuajn\u00eb nga kontraktura t\u00eb plota ndihen t\u00eb forcuar dhe duken t\u00eb keqformuara, t\u00eb anasjellta ose asimetrike. N\u00ebse kemi t\u00eb b\u00ebjm\u00eb me nj\u00eb gjendje t\u00eb avancuar shum\u00eb, mund t\u00eb b\u00ebhet shkak i dhimbjeve t\u00eb forta.<\/p>\n\n\n\n A ka ndonj\u00eb m\u00ebnyr\u00eb p\u00ebr t\u00eb ndaluar dhe rikuperuar kontraktur\u00ebn kapsulare?<\/strong><\/p>\n\n\n\n N\u00eb fazat m\u00eb t\u00eb hershme po, ka mjete dhe m\u00ebnyra jo kirurgjikale p\u00ebr parandalimin e kontraktur\u00ebs kapsulare, duke p\u00ebrfshir\u00eb masazhimin e implanteve dhe p\u00ebrdorimin e medikamente t\u00eb ndryshme.<\/p>\n\n\n\n Meqen\u00ebse bakteret n\u00eb shumic\u00ebn e rasteve jan\u00eb shkaktare p\u00ebr gjendjen e krijuar, mund t\u00eb presupozohet se antibiotik\u00ebt luajn\u00eb nj\u00eb rol t\u00eb r\u00ebnd\u00ebsish\u00ebm. Por kapsula \u00ebsht\u00eb shum\u00eb avaskulare, nuk ka nj\u00eb furnizim t\u00eb mir\u00eb me gjak, k\u00ebshtu q\u00eb antibiotik\u00ebt dhe gj\u00ebrat q\u00eb duhet t\u00eb udh\u00ebtojn\u00eb p\u00ebrmes qarkullimit t\u00eb gjakut nuk mund t\u00eb hyjn\u00eb leht\u00eb n\u00eb kapsul\u00eb. N\u00eb vend t\u00eb k\u00ebsaj, kirurg\u00ebt priren t\u00eb mb\u00ebshteten n\u00eb medikamentet e astm\u00ebs si Singulair, frenuesit e leukotrienit me q\u00ebllim parandalimin e procesit inflamator si pjes\u00eb p\u00ebrb\u00ebr\u00ebse e kontraktimetve kapsulare. K\u00ebto medikamente mund t\u00eb rezultojn\u00eb shum\u00eb efikase p\u00ebr t\u00eb liruar kontraktur\u00ebn e indeve t\u00eb krijuar tek pacient\u00ebt me implant t\u00eb gjirit.<\/p>\n\n\n\n Ka patur diskutime t\u00eb ndryshme n\u00eb lidhje me p\u00ebrdorimin e ultratingujve p\u00ebr t\u00eb ndihmuar n\u00eb shp\u00ebrb\u00ebrjen e kontrakturave, megjith\u00ebse efikasiteti i tij \u00ebsht\u00eb i diskutuesh\u00ebm dhe \u00ebsht\u00eb b\u00ebr\u00eb shpesh shkak debati mjek\u00ebsor.<\/p>\n\n\n\n Cili \u00ebsht\u00eb trajtimi p\u00ebr kontraktur\u00ebn kapsulare?<\/strong><\/p>\n\n\n\n Duke aplikuar masazhe dhe duke p\u00ebrdorur medikamente n\u00eb koh\u00ebn e duhur, disa pacient\u00eb mund t\u00eb mos avancojn\u00eb n\u00eb kontraktur\u00eb m\u00eb t\u00eb r\u00ebnd\u00eb kapsulare.<\/p>\n\n\n\n N\u00ebse ndodheni n\u00eb faz\u00ebn kur kapsulat ngurt\u00ebsohen dhe kontraktura b\u00ebhet e dukshme, nuk mbetet shum\u00eb p\u00ebr t\u00eb b\u00ebr\u00eb, p\u00ebrve\u00e7se ta \u00e7oni pacientin p\u00ebrs\u00ebri n\u00eb sall\u00ebn e operacionit p\u00ebr nd\u00ebrhyrjen e rradh\u00ebs. Kirurg\u00ebt heqin implantet dhe kapsulat n\u00eb zon\u00ebn p\u00ebrreth para se t\u00eb vendosin implante t\u00eb fresk\u00ebta, ndonj\u00ebher\u00eb s\u00eb bashku me nj\u00eb matric\u00eb dermale akellulare (nj\u00eb rrjet\u00eb kirurgjikale mb\u00ebshtet\u00ebse), e cila ka rezultuar t\u00eb ndihmoj\u00eb n\u00eb uljen e p\u00ebrs\u00ebritjes s\u00eb kontraktur\u00ebs kapsulare.<\/p>\n\n\n\n Nga ana tjet\u00ebr, kompanit\u00eb kryesore t\u00eb prodhimit t\u00eb implanteve t\u00eb gjirit e din\u00eb fare mir\u00eb se kontraktura kapsulare mund t\u00eb ndodh\u00eb, k\u00ebshtu q\u00eb t\u00eb gjitha ofrojn\u00eb implante falas, p\u00ebr rritjen primare, p\u00ebr nj\u00eb periudh\u00eb t\u00eb caktuar kohe, si dhe nj\u00ebfar\u00eb shume parash p\u00ebr t\u00eb mbuluar kostot kirurgjikale brenda dy viteve t\u00eb para.<\/p>\n","protected":false},"excerpt":{"rendered":" N\u00eb nj\u00eb k\u00ebndv\u00ebshtrim t\u00eb past\u00ebr biologjik, trupi i njeriut endet instinktivisht mes rrjet\u00ebs s\u00eb indeve dhe objekteve q\u00eb nuk i njeh si t\u00eb vetat, p.sh implantet e gjirit dhe pajisjet e tjera mjek\u00ebsore, n\u00eb m\u00ebnyr\u00eb q\u00eb t\u00eb shmang\u00eb nd\u00ebrhyr\u00ebs t\u00eb ndrysh\u00ebm nga jasht\u00eb. N\u00eb m\u00ebnyr\u00eb tipike dhe natyrale, ajo mas\u00eb e krijuar mbetet e but\u00eb […]<\/p>\n","protected":false},"author":1,"featured_media":96,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-95","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"mb":[],"mfb_rest_fields":["title"],"_links":{"self":[{"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/posts\/95","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/comments?post=95"}],"version-history":[{"count":0,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/posts\/95\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/media\/96"}],"wp:attachment":[{"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/media?parent=95"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/categories?post=95"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.drgeratagani.com\/sq\/wp-json\/wp\/v2\/tags?post=95"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}